Abstract
BackgroundTo develop and test the feasibility and initial effectiveness of the Treatment and Education Approach for Childhood-onset Lupus (TEACH) protocol, a 6-session cognitive behavioral therapy (CBT) intervention for adolescents and young adults (AYA) with childhood-onset systemic lupus erythematosus (cSLE).MethodsFemales with cSLE (n = 14; ages 13–19 years, M = 16.21 years) presenting to a pediatric rheumatology clinic subsequently completed the protocol, which was iteratively modified based on participant/interventionist feedback. Upon intervention completion, participants provided qualitative data on feasibility, acceptability, potential modifications, and perceived effectiveness of the program via a semi-structured interview, which was analyzed for shared themes. Participants also completed measures of fatigue, psychological distress, and pain intensity before and after the intervention. Nonparametric statistics were conducted to examine changes in outcome measures following the intervention.ResultsDuring the study, several protocol modifications were employed to better address the unique needs of individuals with cSLE (e.g., separate content for adolescents versus young adults). Results suggest that TEACH is feasible, acceptable, and potentially effective in the management of cSLE symptoms. Following the intervention, there was a statistically significant reduction in fatigue (Z = − 2.81, p < .01) and depressive symptoms (Z = − 2.69, p < .01). Reductions in pain and anxiety symptoms were marginal.ConclusionsTEACH, a tailored CBT protocol for AYA with cSLE, is a feasible and potentially effective intervention for the management of fatigue and depressive symptoms. Future directions include testing the protocol in a larger controlled study.
Highlights
Introduction and overview of program PsychoeducationCaregiver/significant other guidelines Participant Activity pacingRelaxation Sleep hygienePleasant activity planning Communication strategiesParticipantPleasant activity planningMedication adherenceProgressive muscle relaxation Sleep hygieneCaregiver check-in
The current study aimed to develop and refine the Treatment and Education Approach for Childhood-onset Lupus (TEACH) protocol, a brief cognitive behavioral intervention tailored for AYA with childhood-onset systemic lupus erythematosus (cSLE), and to assess preliminary evidence of feasibility, acceptability, and impact on symptoms of fatigue, psychological distress, and pain
Results provide preliminary support that TEACH is effective in improving fatigue and mood symptoms in AYA diagnosed with cSLE
Summary
Introduction and overview of program PsychoeducationCaregiver/significant other guidelines Participant Activity pacingRelaxation Sleep hygienePleasant activity planning Communication strategiesParticipant (plus caregiver for adolescents)Pleasant activity planningMedication adherenceProgressive muscle relaxation Sleep hygieneCaregiver check-in. To develop and test the feasibility and initial effectiveness of the Treatment and Education Approach for Childhood-onset Lupus (TEACH) protocol, a 6-session cognitive behavioral therapy (CBT) intervention for adolescents and young adults (AYA) with childhood-onset systemic lupus erythematosus (cSLE). Only one CBT program has been tested among adolescent females with cSLE; there was no significant overall improvement in the CBT group as compared to control conditions [12]. This intervention was delivered almost exclusively via computerized modules and was not tailored to target the psychological difficulties common in youth with cSLE.
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